NeuroRehabilitation - Volume 40, issue 1

Article Type: Editorial

DOI: 10.3233/NRE-161448

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 1-1, 2017

Article Type: Obituary

DOI: 10.3233/NRE-161414

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 3-4, 2017

Article Type: Other

DOI: 10.3233/NRE-171449

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 5-7, 2017

Article Type: Other

DOI: 10.3233/NRE-171450

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 9-10, 2017

Authors: Nikles, Jane | Mitchell, Geoffrey | McKinlay, Lynne | Waugh, Mary-Clare | Epps, Adrienne | Carmont, Sue-Ann | Schluter, Philip J. | Lloyd, Owen | Senior, Hugh

Article Type: Research Article

Abstract: BACKGROUND: There is controversy about whether central nervous system stimulant (CNS) medication is an effective method of treating acquired attention deficits in children with acquired brain injury (ABI). OBJECTIVE: The primary objective was to determine the effectiveness of stimulants on attention, concentration and executive function in children with ABI. METHODS: Randomised, double-blind, placebo-controlled, multi-centre n-of-1 trials of stimulants assessing effect on attention, concentration and executive function in 53 children and adolescents with ABI who were outpatients of three tertiary hospitals in Australia. Trials consisted of 3 two-week cycles, each cycle consisting of stimulant medication at …doses titrated by physician (1 week) and placebo (1 week) in random order. The effect on parent and teacher Conners’ 3 and Behaviour Rating Inventory of Executive Function (BRIEF) was analysed using hierarchical Bayesian methods. RESULTS: Overall, Teacher Conners’ Hyperactivity/Impulsivity and Teacher BRIEF Global Executive scales showed important improvement (T-score mean change 2.6; 95% credible interval (CI): 0.4, 4.9; posterior probability of mean change >0 : 0.99; T-score mean change 3.1; 95% CI: –0.1, 6.4; posterior probability of mean change >0 : 0.97). There were no important improvements in parent/guardian-reported primary outcomes. There was heterogeneity in response identified through individual results of the N-of-1 trials. CONCLUSIONS: N-of-1 trials have a clear role in identifying those children/adolescents with ABI and secondary Attention Deficit Hyperactivity Disorder (ADHD) who have important improvements, or worsening on stimulants. The results can only be generalized to children/adolescents who have an apparent pre-trial clinical effect from stimulants. Show more

Keywords: Paediatrics, traumatic brain injury, acquired brain injury

DOI: 10.3233/NRE-161386

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 11-21, 2017

Authors: Tang, Qilin | Lei, Jin | Gao, Guoyi | Feng, Junfeng | Mao, Qing | Jiang, Jiyao

Article Type: Review Article

Abstract: BACKGROUND: Estimating the prevalence of persistent vegetative state (PVS) following severe traumatic brain injury (sTBI) and its change over time is important for the study of the disease. OBJECTIVE: To estimate the prevalence of PVS at six months after sTBI and its trend over the past four decades, and to explore the effect of demographic data, such as age and sex, on the prevalence of PVS. METHOD: Observational studies presenting the prevalence of PVS or the number of patients with PVS at six months after sTBI were included in the analysis. The overall prevalence and …prevalence within pre-defined time intervals were calculated and meta-regression analysis was performed to assess the effect of age, gender, and time on the prevalence. RESULTS : Twenty articles reporting 21 cohort studies were included. The overall prevalence of PVS at six months after injury was 2.77% (95% CI 0.0204-0.0375). There was no statistically significant trend towards time (P  = 0.77). And we found no differences in prevalence according to age (P  = 0.68) and gender (P  = 0.57). CONCLUSIONS : Prevalence of PVS at six months after sTBI has no significant change over the past four decades. Age and gender do not seem to have a significant effect on the prevalence. Show more

Keywords: Severe traumatic brain injury, persistent vegetative state, prevalence, meta-analysis

DOI: 10.3233/NRE-161387

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 23-31, 2017

Authors: Vanderbeken, Ines | Kerckhofs, Eric

Article Type: Review Article

Abstract: OBJECTIVE: To determine whether physical exercise enhances cognition following TBI or stroke. DATA SOURCES: Studies were identified through searches of PubMed, ScienceDirect and the reference lists of papers that were included for full-text evaluation. Medical subject headings from three concepts, i.e. brain injury, physical exercise and cognition, were used to incorporate related search terms. STUDY SELECTION: Included were all trials published in English that assessed cognition before and after an exercise intervention in human adults with TBI or stroke. Nine randomized and two non-randomized controlled trials, as well as three single group pre-post studies were …included. DATA EXTRACTION: Relevant data concerning the methods and results of the included studies were extracted. Methodological quality of the RCT’s was evaluated using the PEDro scale. Non-randomized trials were assessed using the Downs and Black checklist. DATA SYNTHESIS: The included trials were generally of medium methodological quality, though often plagued with issues of internal and external validity. The studies exhibited great heterogeneity, rendering a meta-analysis infeasible. CONCLUSIONS: Though well-designed studies are still needed, the preponderance of evidence suggests a positive effect of physical exercise on global cognitive functioning, especially in the chronic stages of a brain injury. Time after injury as well as the duration of the exercise program are mediating factors. Show more

Keywords: TBI, stroke, brain injuries, exercise, cognition

DOI: 10.3233/NRE-161388

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 33-48, 2017

Authors: Avelino, Marcella Rachadel | Montibeller, Cristiane Gonçalves | Luchesi, Karen Fontes | Mituuti, Cláudia Tiemi | Ribeiro, Priscila Watson | Fagundes, Diego Antonio | Furkim, Ana Maria

Article Type: Research Article

Abstract: BACKGROUND: Dysphagia can be a stroke sequelae and may impact patient prognosis. Thrombolytic therapy has been used as a treatment of choice which aims to reduce sequelae. OBJECTIVE: Assess the ability of dietary intake orally in subjects undergoing thrombolytic therapy and compare it with non-thrombolytic subjects post-ischemic stroke. METHODS: Documentary cross-sectional study with 87 post-ischemic stroke patients. Subjects were divided as to the type of neurological intervention: group 1 consisted of subjects undergoing brain reperfusion therapy or thrombolysis and group 2 for those undergoing no such therapy or non-thrombolysed. Data was obtained from the subjects …relative to age, sex, level of oral dietary intake at the beginning of hospitalization and at discharge, length of hospital stay, comorbidities and site of neurological lesion. RESULTS: Group 1 was composed of 39 patients while 48 patients were in group 2. Both groups consisted of subjects with similar mean age and balanced gender distribution. Both groups presented hypertension as the most frequent comorbidity. The individuals in group 1 demonstrated improvement of oral dietary intake (p  = 0.002) and shorter hospital stay (p  = 0.007) when compared with group 2. CONCLUSION: There was greater improvement of oral dietary intake and shorter hospital stay for patients undergoing thrombolytic therapy. Show more

Keywords: Stroke, deglutition, dysphagia, swallowing disturbances, thrombolytic therapy

DOI: 10.3233/NRE-161389

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 49-55, 2017

Authors: Silva, Paula Fernanda de Sousa | Quintino, Ludimylla Ferreira | Franco, Juliane | Rodrigues-de-Paula, Fátima | Albuquerque de Araújo, Priscila | Faria, Christina Danielli Coelho de Morais

Article Type: Research Article

Abstract: BACKGROUND: Stroke subjects show poorer sit-to-stand (STS) performance when compared to matched-healthy subjects, but it is still unclear the trunk role in this poorer performance. OBJECTIVES: To compare the trunk kinematics related to the generation/transfer of the flexor momentum during the STS task between stroke and matched-healthy subjects, and to investigate if there were relationships between these variables and STS performance. METHODS: Eighteen chronic stroke survivors and 18 matched-healthy subjects were assessed. The score of the five-repetition STS test and the total/phases duration of the STS (motion analysis system) at both self-selected/fast speeds characterized STS …performance. Trunk kinematic variables were maximum forward flexion, peak flexor momentum, and its temporal framework in the STS. Between groups comparisons (Independent Student’s t -tests) and correlations (Pearson correlation) were performed (α = 0.05). RESULTS: Stroke subjects showed poorer STS performance, greater values of maximum forward flexion at fast speeds, and a lower peak flexor momentum at both speeds (0.001≤p ≤0.022). In general, the correlations were significant, moderate (0.001≤p ≤0.028), and positive to maximum forward flexion (0.37≤r ≤0.54) and negative to peak flexor momentum (–0.58≤r ≤–0.71). CONCLUSIONS: The poorer STS performance in stroke survivors is associated to the kinematic changes of the trunk related to the poorer ability to generate/transfer the trunk flexor momentum. Show more

Keywords: Stroke, activities of daily living, mobility, trunk, reabilitation

DOI: 10.3233/NRE-161390

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 57-67, 2017

Authors: Jeon, Somyung | Kim, Young | Jung, Kyoungsim | Chung, Yijung

Article Type: Research Article

Abstract: OBJECTIVES: The purpose of this study was to examine the effects of task-oriented electromyography-triggered stimulation for shoulder subluxation, muscle activation, pain and upper extremity function in hemiparetic stroke patients. METHODS: Twenty participants with subacute hemiparetic stroke were recruited for this study and were randomly divided into two groups: experimental group (n  = 10) and control group (n  = 10). Subjects in the experimental group participated in task-oriented electromyography triggered stimulation for 30 minutes, five times a week for four weeks, whereas the control group received cyclic functional electrical stimulation for 30 minutes, five times a week for four weeks. …Subjects in both groups received conventional physical therapy for four weeks (30 min/day, five times/week). Data collected included the degree of shoulder subluxation which had been confirmed by X-ray, muscle activation of the supraspinatus and posterior deltoid muscles by electromyography, pain by the Visual Analogue Scale (VAS), and hand function by the Fugl-Meyer Assessment (FMA) before and after the four week exercise period. RESULTS: The results showed significant improvement in shoulder subluxation, muscle activation, and VAS results in the experimental group, compared with the control group(p  < 0.05). FMA scores showed no significant differences between the two groups. CONCLUSIONS: In conclusion, task-oriented electromyography-triggered stimulation improved shoulder subluxation, muscle activation, pain and upper extremity function. These results suggest that task-oriented electromyography-triggered stimulation is effective and beneficial for individuals with subacute stroke, and that further studies should be conducted on multivarious anatomical regions. Show more

Keywords: Stroke, subluxation, task oriented exercise, electromyography triggered stimulation

DOI: 10.3233/NRE-161391

Citation: NeuroRehabilitation, vol. 40, no. 1, pp. 69-75, 2017